Integrating Lab Work into Centering Visit

Hi Stefanie,
  There are a couple ways to approach this.  One consideration I want you to consider is that you might avoid lab draws in the same space where you are serving food; at the very least discuss how you approach it with your infection control team.  I have managed this matter in a couple ways.  One way is to work out a relationship with the lab to be able to give the glucola yourselves, make sure your clocks are reading the same time as theirs, and stagger giving glucolas at the beginning and middle of group.  You can also offer the option of a post group draw and give it to those pt's between break and end time (earlier the better so they don't have to stay too long).  If they won't let a provider or RN give the glucola, then you can stagger having lab come up at those intervals but this will be more disruptive and unrealistic from their standpoint depending on staffing.  I have also sent a couple down after their  initial assessment to drink the glucola while I am seeing the remaining members of group, then taking a break when the draws are due and sending two more down to drink the glucola, which puts the lab drawn usually at the end of group if timed right.  Hopefully this is making sense.  Where I worked our 28 wk labs were:  50g glucola, CBC, HIV, and RPR.  At 36 weeks we would have the patients self swab in the bathroom for GBS and GC/CT cultures after group instruction.   Oh one other note;  given I would know going into group who needed labs, and if there were ever other labs needing to be drawn, I would just write them on a paper for my  nurse co-facilitator who would enter orders as I'm seeing the patient and the others are checking their vitals.  This way the orders weren't entered prior to arrival and "arriving" a patient in case they no showed, and also so the orders were there for those who went to lab during the initial assessment period.  It flowed pretty smoothly for us doing it this way.  We did have the ability for awhile to give glucolas however unless you have clear system of communication in place be aware you run the risk of them getting two if the lab doesn't know they received it.  We trialed putting bracelets on the patients with the time they received the glucola, as we ran into patients either not telling them or not being able to tell them and not giving them the paper with the information.  We did well with that, however due to other system changes (new EMR) they stopped this process in our practice. Hopefully this helps, and makes sense. Please let me know if you have any questions.

Mary